Mom and Me

Mom Time

It seems, when you are Mom's age you have your own internal clock. Two weeks ago we went to the doctor for some tests.  Spent nearly an hour there and she says, "I'm hungry."

Knowing this might be the case I had packed, at her instruction, a couple of cereal bars.

"Do I have a bar in my purse?"

Yes,

"Good!  Let's eat."

So, there she was...taking her sweet time for a snack.  It's all on "Mom Time".

And...so it goes.

For those of you wondering...since our last post Mom has been in and back out of Hospice.  She is home now and seems to be doing the best she can.  Thanks for your thoughts...

Scary Times...

Mom has been taking Warfarin as a blood thinner for years.  She has atrial fibrillation so she needs to maintain a specific level of "thinness" for her blood.  It's monitored on a regular basis and the amount of blood thinner she takes changes from two to three milligrams a day...again depending on her Prothrombin Time (clotting time).

Because her warfarin pills come in one milligram doses she'll take two or three tablets depending on the directions from her physician.

Two weeks ago I called her primary physician and asked if they might call in another prescription because she was running out.  She had been getting the pills from a mail-order facility but because he local Hy-Vee is so close we switched to them.

The new pills were a different color and when I asked about that I was told that depending on where they come from they are different colors.  Her dose was two pills (two milligrams) for five days and three pills (three milligrams) for two days. 

On Wednesday we went in for lab work.  Mom usually runs a PT of 2.4 to 2.6.  The tech looked up from the test and said, "Oh my!  She is testing at an 8!"  That means her blood is very, very thin.  They did the test again and we were told to immediately head to the Emergency Room where they would check her out and give her some Vitamin K which thickens the blood.

Seven hours later we were home and told to have her blood checked again on Friday (Today).

When we got home from the hospital it didn't make sense to me that she would, for no reason at all, spike her PT.  So I examined the bottle and for some unexplained reason her physician had switched from one milligram of warfarin pills to three milligram pills.  So, rather than getting 2 - 3 milligrams of warfarin a day she was getting six to nine milligrams!

Nobody had caught it.  And we're still not sure why there was a change in the script.  We'll find out...

As of Friday afternoon she had come back down to 5.5 but...that's still pretty high and by 5PM we had still not heard back from her physician.

Two words:  Buyer...Beware.

And...so it goes.

 

Listen to the Patient

Over the past week Mom has been complaining that, "I'm not right in the head!" and that she was feeling "goofy".  Her blood pressure had gone up just prior to her recent hospitalization so she was prescribed some new meds. 

"I'm telling you, this stuff makes me feel like I'm in another world."

Then, at the hospital they prescribed a second blood pressure medication.  By the time she got back to Edgewater she was not the same.

Early this week we had a care staff meeting and we talked over several items from her anxiety to her inability to concentrate.  She said, "Look, I don't know what this stuff is but I am now starting to hallucinate.  Just this morning I was talking to my family of 40 years ago and I was wide awake."

Besides that Mom was very upset that she was taking eleven pills at a time, "I am not a pill-taker and I'm always careful with what interacts with what."

Within twenty-four hours of discontinuing several drugs Mom was...back.

When we visited about this yesterday she said, "See, I told you I was wacky.  I'm glad they finally listened."

Word to those of you with elderly family members.  You must stay intimately involved in the day-to-day care of your loved ones.  Do not fail to question what is going on and build a solid relationship with the licensed caregivers.  It makes a huge difference.

And...so it goes

Meeting The Kindest People on the Planet

Over the course of the past week I've, thanks to Mom, met some of the kindest people on the planet.  Mom has been at Edgewater a Wesley Community in West Des Moines/Waukee and, thanks to their alert staff, they made sure Mom was transferred to Mercy West Lakes last Thursday.  She was in pretty bad shape with a urinary tract infection (that had just started) some congestive heart failure and confused beyond belief due to the UTI.

Having spent ten years as a long-term health care administrator I have now often wondered how many women, who were diagnosed with dementia, really had a UTI.  I shudder to think of that reality.

At Mercy West Lakes they start each morning with a prayer.  What I heard was not so much as a prayer for the patients but for the staff who care for the ill and infirm.  I'm not Catholic nor a Christian but I found that prayer to be a refreshing reminder of how important the work these wonderful people do.

People like Rachel an RN who is just 24 but delighted in coming into Mom's room to talk "girl stuff" for the longest time.  Or TerriSue a social worker whose job it is to be helpful...but she has an amazing talent for being real and kind and considerate.  You don't teach that stuff...it comes from inside. Or Lynn the ER Doc who brought tears to my eyes when she said, "You can call me Lynn and know that we will do our best for your Mom.  We all have mothers."

And Ginger from Edgewater who, on her day off called back to the skilled care facility to see when Mom might come back so she could make sure there was a bed for her in "her wing".  And Katy and Amber and Mary and Carrie and Angie and the list goes on and on and on...all warm, welcoming, wonderful people who are...kind...first.

In the end I have my Mother to thank for introducing me to these kind people.  You all make a difference in the lives of the people you touch and we are grateful.  Your actions and words restore hope and that...is the greatest kindness.  Thank you.

And...so it goes.

Meanwhile...Back at the Hospital

It's been quite the week.  Mom was to have been discharged from the skilled care unit of Edgewater on Wednesday.  However on Tuesday she was exhibiting some strange behavior and by 2PM of the next day I met with senior level staff and voiced concerns about her release.

We combed through her records and the staff found several things that led them to believe she may have a urinary tract infection (UTI).  That doesn't sound like a big deal however, it can cause elderly folks to lose cognitive ability.  She was approved to stay a few more days.

By Thursday morning the staff was faced with my Mother calling out to her Mother and saying they were going on a picnic.

If was off to the hospital at Mercy West Lakes.

The ER physician called not only the UTI correct but also expressed concern about several other medical issues and she was admitted.

The hospital staff pumped her full of some strong antibiotics and by 2PM she was sitting up, having a meal and wondering what all the fuss was about.  Do you remember yesterday, Mom?

"Of course I do."

Do you remember calling out for your Mother and asking about packing up dishes?

"Why would I do that?"

We talked about what had gone on.  She shook her head and said, "I was really looney huh?"

Yes.

It's tough to see your parents age and become infirm.  My Father z"l didn't go through any of that.  He died of a massive heart attack 26 years ago last week.  So, this is a new experience and one that so many of you have gone through or will.

Kindness and committed health care professionals can make all the difference.  Yesterday as the ER Doc was visiting with me and telling me, "We are going to do everything we can to help your Mother recover.  After all, it is your Mother."  I offered my thanks and tears welled up in my eyes. She said, "Michael, my name is Lynn.  We all have a Mother and I get it.  We are here for her and for you."

Thank you...all.

And...so it goes.

(Photo:  Mom and her grandson, Aaron at a Chanukah meal - December 2012)

The Catholics...

Last evening I got a call from an orthopedic surgeon from Mercy West Lakes regarding Mom's back. It wasn't bad news but it wasn't good news either.

Mom is suffering from compression fractures. She's had them before and they too took her out for some time.  However, that was several years ago and now, being close to 93 (in just four days) the healing process is much different.

The options are to get her up and moving more and perhaps...perhaps do some less invasive surgery.

The trick now is to get her motivated to move.  When I was with her last night she was not happy with her progress.

"This is really getting to me."

I know.

"I've been hurting for over a week and just can't seem to get any relief.  But, I will tell you something, these Catholics are OK."

What?

"No kidding.  If you want excellent care head to a Catholic hospital it's just something about them."

But, I suspect many of your caregivers are not Catholic.

"Doesn't matter.  I think they train them right and that's what's important."

And...so it goes...

What A Week...

As you know, last Sunday we were in the emergency room at Mercy West Lakes.  Then it was to the family doctor on Wednesday and on Thursday it was back to the hospital where they admitted Mom.

She's been complaining of severe back pain and some other stuff.  Following three visits to the medical community they decided to dig in and see what's going on.

Now, a week later she is feeling better but still no direct cause.  However this time has not been without it's moments.

Friday the folks from physical therapy came in to visit with her:

Hello June, we are from Physical Therapy and here to evaluate you.

"Oh oh, I've been through this before.  You're the people who throw me around like a rag doll."

Oh no we will be careful.

"You better be.  Say, where are you from?"

Where do you think?

"India!"

That is correct.

"I knew it.  I really like you people.  Your medical staff are smart and caring and I've had some experience with Indian physicians."

(I was glad that didn't go some place else...)

And this:

Mom, can I bring you anything?

"Yes, I need some make-up."

But you are in the hospital.  Most folks don't much care what they look like when they are trying to get better.

"That's the problem and I'm not 'most folks'.  Looking better makes me feel better."

And if that's all it takes...I'm in.

And so it goes....

A Little Hospital Time

Mom has a bad back.  Several years ago she had compression fractures in the cervical area.  She has osteoporosis and like she says, "Some things are wearing out."

Late last week she was bending over "ironing" her jeans.  She was dusting in the bedroom and messing around in the kitchen.

It was all a little too much and by Sunday, about the time I was to have been with friends I got the call:

"Michael, I think I'm in trouble."

That's a switch.  Usually it's me.

"No, my back hurts so badly I can hardly move."

I drove up the hill and fifteen minutes later we were at the swanky new hospital, Mercy West with some nice people.

"Must be a slow day", said Mom.  The place was nearly deserted.

After the x-rays and a shot for pain we left...four hours later.

It was not the best of times but, it could have been worse.

"You know what?  It just sucks to get old."

I get it Mom.

And so it goes....

Let's Check Those Eyes...

It was off to the Wolfe Eye Clinic today for a follow up visit.  Mom has issues with "dry eyes" and six months ago the doctors did a procedure and it seemed to help.  This was a follow up visit.  Before seeing the doctor Alex did some tests.  You know...reading the eye charts and assorted stuff. (I was amazed at his talent.)

She did pretty well for 93 and the doctor said, Everything looks good June.  In fact we're pretty impressed that your vision is 20/30.

"What should it be?"

We see lots of patients with much worse vision than you.

"So why did I give up my drivers license?"

Well, lots of things go into driving besides eyesight.

"I know, they say you slow down at about 90."

Some people slow down way before that.

"I've heard that but don't believe it."

What do you think about glasses?  Did you ever wear them?

"Oh yes!  Back in the '50's some quack suggested that I should get bi-focals and all they did was make me dizzy.  Couldn't stand them."

Would you consider changing your mind?

"Only if you promise me you are not a quack!"

And so it goes....